Safeguarding Adults Overview for PHC

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Safeguarding Vulnerable Adults

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Safeguarding:

Safeguarding Protecting Vulnerable Adults John R. Kimberley

Learning Outcomes:

Learning Outcomes Recognise the circumstances and issues that make adults vulnerable to abuse Recognise evidence of abuse and what might indicate that abuse has been, or is, taking place Demonstrate an understanding of the factors that might increase the risk of abuse Report abuse according to the current North Somerset Safeguarding Adults policy, including use of effective recording methods and understanding issues regarding the contamination of evidence Work in a manner that minimises the risk of abuse to vulnerable adults Recognise the impact of relevant legislation and guidance on their practice with vulnerable adults, including the Mental Capacity Act and the Personalisation agenda Show an understanding of the principles and values of Safeguarding Adults practice, including issues of equality and diversity and dignity in care

Who is vulnerable?:

Who is vulnerable? Someone who is or may need community care by reason of physical, mental disability, illness or age. Unable to look after themselves Unable to protect themselves against harm or exploitation Age 18+ (No Secrets 2000)

Vulnerable Adults:

Vulnerable Adults People with disabilities People with sensory impairment (blind or partially sighted, deaf or hard of hearing People with mental health needs including Dementia and Alzheimer's People who misuse substances or alcohol People who are physically or mentally frail

Definition of Abuse:

Definition of Abuse Single repeated action or omission or lack of appropriate action, occurring in any relationship where there is an expectation of trust, which causes harm or distress. (Action on Elder Abuse 2004/5, WHO) Violation of an individual’s human or civil rights by any other person(s) (No Secrets DOH 2000)

Legislation:

Legislation No adult Protection Act Less awareness than children “No Secrets” guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse (DOH 2000) Criminal acts (assault, theft, rape)

Legislation:

Legislation Safeguarding Vulnerable Groups Act: vetting and barring 2006 Responding to Domestic Abuse: A Handbook for Heath Professionals (2005) Mental Capacity Act 2005

Mental Capacity Act:

Mental Capacity Act Presumption of capacity – right to make own decisions. Right to be supported in making own decisions. Right to make what might be seen as eccentric or unwise decisions. Best interest is anything done for or on behalf of the a person should be in their best interest. Less restrictive intervention to basic rights and freedoms.

Types of Abuse:

Types of Abuse 9 No Secrets (2000) has identified the following types of abuse: Physical Sexual Psychological Neglect or acts of omission Discriminatory Financial Institutional

Physical :

Physical ALWAYS A CRIME BUT NOT ALWAYS PROSECUTED: Administration of medicine that is not licenced for the purpose being used. Described as ‘soft coshh’ because of the impact it can have. Hitting and slapping, pinching, pulling, pushing, kicking, control and restraint Force feeding Involuntary isolation 10

Signs of Abuse:

Signs of Abuse Cuts, wounds, punctures, bruises, burns, black eyes, burns, fractures Poor skin condition or hygiene Dehydration/Malnourished without an illness related cause Loss of weight Broken glasses/frames Signs of being restrained 11

Sexual:

Sexual RARELY DISCUSSED Can be a result of opportunism; care worker chance to assault a dependent person Some cases are planned (some people target care or sheltered homes as they contain older people. Domestic violence Incestuous relationships One of the challenges of elderly sexual abuse is often denied and preservation of forensic evidence is lost through kindness of others and police are not informed 12

Signs of sexual abuse:

Signs of sexual abuse Bruises around the breast and genital area STDs Unexplained vaginal or anal bleeding Difficult in walking or standing Changes in behaviour 13

Psychological:

Psychological MOST COMMON TYPE OF ABUSE REPORTED Can have a profound effect on someone’s mental health Helplessness Confusion and disorientation Anger without apparent cause, agitation Unusual behaviour (sucking, biting, rocking) 14

Signs of Psychological Abuse:

Signs of Psychological Abuse Often linked with financial abuse in the elderly Fears, flinching, helplessness Confusion and disorientation Extremely withdrawn, non communicative or non responsive Anthony Chirara 15

Neglect or Acts of Omission:

Neglect or Acts of Omission 16 Failure to provide food shelter or clothing, failure to provide medical care, hygiene or personal care, inappropriate use of medication, denial of educational, social and recreational needs, lack of stimulation or emotional warmth.

Indicators of Abuse:

Indicators of Abuse DESCRIMINATORY: lack of respect, substandard service based on gender, race, religion e.t.c INSTITUTIONAL: lack of privacy, dignity and respect, restricted access to facilities, lack of choice and control, poor standards and training Anthony Chirara 17

Where?:

Where? Person’s own home Relative or friend’s home Care or Nursing Home A day centre or support service Within a sheltered or supported living scheme Within an adult placement Within an educational establishment A hospital Anthony Chirara 18

Frequency of Abuse Cases:

Frequency of Abuse Cases Financial abuse 35% Physical abuse 25% Psychological 20% Neglect 9% Sexual 8% Institutional 1.4% Anthony Chirara 19

Cont’d……:

Cont’d…… Total referrals for older people 58% of all alerts Total referrals for people with Learning disabilities 20% of all alerts Total referral of people with physical disabilities 13% of all alerts Total referrals of people with mental disabilities 7% of all alerts Anthony Chirara 20

Who is the abuser:

Who is the abuser A partner, relative or member of a social network A carer (paid or unpaid) Professional staff A volunteer or member of a community or faith group Other vulnerable people who may be using a social or health care service Someone who forms a relationship with a vulnerable adult to exploit them 21

Alleged Perpetrators:

Alleged Perpetrators Care Workers 31% Relatives 21% Friend 10% Spouse/Partner 3% Health Worker 2.8% Other V/A 2.8% Stranger 2.8% Neighbour 2.2% N/K 19% Anthony Chirara 22

Responsibilities :

Responsibilities Ensure safety of individual Preserve evidence consult/call police if appropriate Report to manager/POVA lead Follow local procedures and time scales Inform Social Services RECORD Do Not Ignore It 23

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